Post-Ebola Awakening: Urgent Call for Investing in Maintaining Effective Preparedness Capacities at the National and Regional Levels in Sub-Saharan Africa

Abstract

Background: The 2014 Ebola outbreak reminded us of the importance of preparedness for addressing health security threats. Learning from this experience, we aim to (1) enhance the understanding of preparedness by policy and decision makers, (2) discuss opportunities for Africa to invest in the prevention of health security threats, (3) highlight the value of investing in preventing health security threats, and (4) propose innovations to enhance investments for the prevention or containment of health security threats at the source. Methods: We used observations of governments' attitudes towards investing in preparedness for health security prevention or containment at the source. We conducted a literature review through PubMed, the World Wide Web, and Mendeley using the keywords: "health emergency financing", "investing in health threats prevention", and "stopping outbreaks at the source". Results: Countries in sub-Saharan Africa invest inadequately towards building and maintaining critical capacities for preventing, detecting, and containing outbreaks at the source. Global health security emergency funding schemes target responses to outbreaks but neglect their prevention. Governments are not absorbing and maintaining adequately capacity built through GHS, World Bank, and development aid projects -a lost opportunity for building and retaining outbreak prevention capacity. Recommendations: Governments should (1) allocate adequate national budgets for health honouring the Abuja and related commitments; (2) own and maintain capacities developed through International Development Aids, OH networks, research consortia and projects; (3) establish a regional health security threats prevention fund. The global community and scientists should (1) consider broadening existing health emergency funds to finance the prevention and containment outbreaks at the source and (2) Strengthen economic analyses and case studies as incentives for governments' budget allocations to prevent health security threats.

A descriptive study of zoonotic disease risk at the human-wildlife interface in a biodiversity hot spot in South Western Uganda

“…This is a reflection of the international and national focus and investment in certain diseases of public health concern such as Ebola, and the neglect of endemic zoonotic diseases that significantly contribute to the disease burden in these communities. This also has implications for zoonotic disease spread and highlights the extent to which education and dissemination of information can mitigate future outbreaks of these zoonotic diseases [37].…”

Global Fund contributions to health security in ten countries, 2014–20: mapping synergies between vertical disease programmes and capacities for preventing, detecting, and responding to public health emergencies

“…Many countries, however, have struggled to adequately invest in building and maintaining the capacities necessary for achieving this goal, and we see this now in the global response to the COVID-19 pandemic. [1][2][3] The International Health Regulations (IHR) are a legally binding framework that represent the existing guiding frame work for health security efforts. 4 The IHR require that member states develop and maintain core public health capacities in ways that avoid unnecessary obstructions to international traffic and trade.…”

Preparedness of health care systems for Ebola outbreak response in Kasese and Rubirizi districts, Western Uganda

“…Decreased budgetary support from the government may be eroding the little gains of preparedness of Uganda’s health care system [ 37 ]. Funding for preparedness is key before, during and after an outbreak [ 38 ]. Resource mobilization at whatever stage of an outbreak, and especially preparedness, is vital because the fight against Ebola epidemics is highly resource intensive.…”

“…During an epidemic situation some infrastructure and health facilities that may not receive funding when the threat level is low will be activated and funded. Countries tend to have more funding for case management and disease outbreak response in general than for preparedness [ 38 ]. Even though our results show that preparedness indicators can be used to monitor the extent of preparedness of communities, this tool seems to have been designed to be used mainly at national and sub-national level rather than community level.…”